March 24, 2014

How the Affordable Care Act is Helping HUD Combat Homelessness

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Note: The Affordable Care Act is already helping millions of Americans, including many people in the community HUD serves. With the deadline to enroll for health insurance on March 31, this week  the HUDdle blog will be devoted to how housing and health care are intertwined and how the ACA is helping us achieve HUD’s mission. There is still time to get covered, so visit for more information.

In my role at HUD, I focus on combating homelessness. In 2010, the Obama Administration launched a federal strategic plan, Opening Doors, to combat homelessness. The goals we set are ambitious, but achievable. We are on track to end homelessness among veterans by the end of 2015; end chronic homelessness by 2016; end homelessness for families, youth and children by 2020; and we are setting a path to eradicate all types of homelessness in the United States. 

Our success in reaching these goals will rely on many factors, and the Affordable Care Act is a critical tool for us. The health care system is changing for the better and there are enormous opportunities to help people who are experiencing homelessness get off the streets and into permanent housing.

If we take advantage of all the opportunities of the Affordable Care Act in order to end homelessness, it will show that no one chooses to be homeless when given a real choice of a place that feels like home and the ongoing community supports to help them stabilize and recover.

Thanks to the Affordable Care Act, states can choose to expand their Medicaid coverage to all adults with incomes below 133% of poverty. In return, states receive 100 percent of federal funding to cover those costs for the first three years and no less than 90 percent federal support for those costs in the years following.

So far, 25 States and the District of Columbia have taken up this Medicaid expansion opportunity, giving millions more of their residents access to affordable health care. If all 25 states that haven’t expanded coverage did, approximately 5.4 million additional uninsured Americans would gain access to health insurance coverage by 2016.

States that have expanded Medicaid have removed the hoops you need to jump through to get people eligible for health benefits. In every state that has expanded Medicaid a person who has been living on the streets and in shelters can now be enrolled for health care.

This will make a huge difference in people’s lives. Many people experiencing homelessness or at-risk of homelessness have serious health needs and pre-existing conditions. Before the Affordable Care Act, these conditions made the barriers to receiving adequate care even greater for those in need and more costly to the general population because their only source for treatment was the emergency room. By expanding Medicaid, we can help people who are experiencing or are on the verge of homelessness stabilize their lives, receive badly needed care and treatment, and give them the opportunity to recover.

The Affordable Care Act creates new incentives for better care for those who need it most and introduces new tools for states to provide more services that could help a person find and retain housing. This means, for people experiencing homelessness, the benefits of the Affordable Care Act can really make the difference between living on the street and having a roof over their heads.

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